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-7- <br />Cerrdficadon: <br />As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements ofthe <br />following terms and conditions: <br />All necessary approvals from local government have been applied for (Section 34-32.5-110(l)(a)(VIII). <br />2. To the best of my knowledge, all sign((i��fii�cantµvaluable and permanent man-made structure(s) in existence at the time this <br />app"i -\NVn V C� and .Icc:.t:.d Il�.rthm 200 acct �of he proposed Y�{==d SY 2 {{M�4 .bccn Yawai'aucd Ll �wSJ Y�.� 14Y{{Vu <br />(Section 34-32.5-115(4)(c), C.R.S.). (NOTE: For 110 operations, the affected area includes all lands delineated by the permit <br />boundary.) <br />3. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), <br />C.R.S.), <br />4. As tYr 4rr1i....w1/..w ,• NV uV{ uWf 4uuai:aiis"�7r pa aIIYYVu .,t..ilvaa.r jaa aY aff4tY ifriViVYd{W f.Yllr LLlaJ \+\ \V\\a4\VUVr <br />{.a <br />the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.). <br />5. I understand that statements in the application are being made undcrpcnaIry ofpcdury and that false statements made herein <br />are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503. C.R.S. 1984. <br />T his form has been approved by the MinedLand Reclamation Boardpursuant to section 34-32.5-Il0,GR.S., of the Colorado Land <br />ReciamatdonActfor theEwwaan of Construction Materials. Any alteration ormadifrradon ofthis form shall result m voiding any <br />permit issued on the altered or modrJ%d form and subject the operator to cease and desist orders and civil penalties for operating <br />without a permit pursuant to section 3¢32.5-123, GR,S <br />Signed and dated this day of111-1911) <br />62 <br />�- Te Cvirva utiiiu \ittwa (.�'iC.ii) <br />App icant/ r <br />I� <br />L <br />Signed: <br />Corporate Secretary or Equivalent <br />TW :: n'/C; ..rn .....t.. nl .a. <br />a{J. •..v..0 J v raa <br />State of . ] <br />_ f ss. <br />County of <br />The foregoing instrument was acknowledged before meth is � � day of r 4—k <br />by �,1 l L= f ..� .. - _ _ as <br />otary blic L _! <br />11t`y C`ommissian expires: �- <br />SIGNATURES MUST BE IN BLUE INK <br />NICOLEKRAUni <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />NOTARY ID 199MM5922 <br />MY COMMISSION EXPIRES OC70SM e,= <br />